The diversion and abuse of controlled substances (CS) is a growing problem in our society. Veterinary practice involves routine use of these substances. Strict monitoring of their use is critical for recording keeping, patient and staff safety, and compliance with laws and regulations.
To prevent misuse, you must recognize the signs of abuse and diversion. Red flags that may indicate a problem at your facility include:
- A significant increase in CS discrepancies, including overfill missing from vials, vials being compromised, and waste inaccuracies.
- Patients experiencing pain after sufficient medication.
- Increased frequency of late documentation.
- Removal of CS without an order.
You may also notice red flags, such as personality and work behavior changes, from the employee who is diverting CS. For example, an employee may start showing up late for work, taking frequent breaks, missing deadlines, and/or showing signs of confusion or difficulty concentrating.
Very effective methods exist to prevent abuse and diversion of CS. One is using technology to keep running tallies and to monitor for discrepancies. Positioning cameras for a double verification is also very helpful. You can also appoint an independent representative who does not have access to the same substances. Make sure your practice has clear policies and that every employee understands and abides by them. Promote a culture of accountability and reporting concerns in a timely manner.
Prevention is the best approach. Remember to limit access to necessary individuals, prescribe only enough of a controlled substance for a specific duration, and communicate clearly with owners to ensure that they understand their responsibilities.
All health care professionals and clients must know and follow best practices to prevent diversion of these medications.
By Erin White, PharmD, Clinical Staff Pharmacist
